EDGAR MANUEL GONZALEZGOMEZ IDC
NPI 1164245403
Military Health Care Provider - Independent Duty Corpsman in San Diego, CA

Active since November 05, 2024
34101 FARENHOLT AVE BLDG 14, SAN DIEGO, CA 92134(619) 532-6266 Get Directions Write a Review

NPPES record last updated: November 5, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Individual
  • Male
  • Military Health Care Provider
  • Independent Duty Corpsman

About EDGAR GONZALEZGOMEZ

This page provides the complete NPI Profile along with additional information for Edgar Gonzalezgomez, a provider established in San Diego, California with a medical specialization in Military Health Care Provider, focusing in independent duty corpsman . The healthcare provider is registered in the NPI registry with number 1164245403 assigned on November 2024. The practitioner's primary taxonomy code is 1710I1002X. The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI
1164245403 Verify this NPI
Provider Name
EDGAR MANUEL GONZALEZGOMEZ IDC
Gender
Male
Entity Type
Individual
Location Address
34101 FARENHOLT AVE BLDG 14 SAN DIEGO, CA 92134
Location Phone
(619) 532-6266
Mailing Address
4765 GURKE ST SAN DIEGO, CA 92124
Mailing Phone
(323) 365-9491
Is Sole Proprietor?
Yes
Enumeration Date
11-05-2024
Last Update Date
11-05-2024
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Military Health Care Provider Independent Duty Corpsman

Taxonomy Code
1710I1002X
Type
Other Service Providers
Taxonomy Description
A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.

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Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14, SURFACE WARFARE MEDICAL INSTITUTE SAN DIEGO, CA 92134
SAN DIEGO, CA 92134
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
Emergency Medicine
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
Military Health Care Provider
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1164245403, enumerated as an "individual" on November 05, 2024.

The provider is located at 34101 FARENHOLT AVE BLDG 14 SAN DIEGO, CA 92134 and the phone number is (619) 532-6266.

Military Health Care Provider with taxonomy code 1710I1002X and a focus in Independent Duty Corpsman.